1. Anthony, Maureen PhD, RN

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Dr. Farid Fata, an oncologist in Michigan was recently sentenced to 45 years in prison for healthcare fraud. His actions were despicable and indefensible. In all he is thought to have harmed 553 patients, diagnosing and treating some for cancer that didn't exist. Others received dangerous doses of drugs, and when it was profitable to him, those who did have cancer were undertreated. Some were denied a peaceful death when he continued to prescribe chemotherapy long after any possibility of therapeutic benefit. His motive? In his own words-power and greed. In all he is thought to have received over $17 million from fraudulent treatment and billing.

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Sadly, had the Michigan Department of Licensing and Regulatory Affairs taken a 2010 complaint by an oncology nurse seriously, at least some of his victims would undoubtedly be alive today (Click on Detroit, 2014). Nurse Angela Swantek interviewed for a position as an infusion nurse at one of Fata's seven clinics and, as part of the process, shadowed one of the clinic nurses. An experienced oncology nurse, she immediately recognized improprieties. For example, a drug that should be administered intravenously over 30 seconds was being administered as an infusion over 1 hour. This kept the patient in the clinic longer, allowing Dr. Fata to bill for the longer time. Swantek observed that the clinic was full-every chair taken by his victims. Appalled by what she saw, she filed a complaint with the Michigan Department of Licensing and Regulatory Affairs (DLRA) the same day, citing specific instances of improper chemotherapy administration and Occupational Safety and Health Administration (OSHA) violations that she observed. As she said later-"I handed him to them on a silver platter."


Sadly, a year passed before her concerns were investigated and the response to Swantek was that her complaint was unfounded. After the charges were brought against Dr. Fata, journalists who were investigating what happened with Swantek's complaint were told by the DLRA director Steven Gobbo, that if Swantek wasn't happy with the result of their "investigation" she should have gone elsewhere (Click on Detroit, 2014). But to whom would she have gone? Doesn't the buck stop there? Wasn't it the responsibility of the DLRA to thoroughly investigate such egregious claims? According to their Web site, their mission is to safeguard Michigan's citizens (DLRA, 2015). Unfortunately they failed, as hundreds of family members and injured patients attested in court.


One can only wonder if she was ignored because she is a nurse. Did the department underestimate the knowledge and expertise of an experienced oncology nurse? Would they have taken a complaint by a physician more seriously? How many other complaints by nurses have been dismissed as unfounded? We cannot let Angela Swantek's unfortunate experience keep us from doing the right thing. As frustrating as this must have been for her, I know she is glad she spoke up, and would advise us to do the same.


On another note, we have some great feature articles for you in this issue. Drs. Patricia Alpert and Tricia Gatlin have written an article on the unfortunately common problem of polypharmacy in older adults. Many home care clinicians will identify with this increasing phenomenon. Dr. Echeverry and colleagues describe an innovative in-home primary care intervention that greatly decreased hospital admissions among a vulnerable group of patients. Dr. Steadman and colleagues describe a newer classification of drug to treat diabetes-the glucagon-like peptide-1 receptor agonists. Because this drug must be administered subcutaneously, patients will need extra instruction and support. Finally, authors Jennifer Volland and Sue Blockberger-Miller have written an important article about the paradigm shift needed for home healthcare agencies to shift from volume- to value-based services. And, as always, our department authors bring you the latest in diabetes, infection prevention, medication safety, and legal matters. Dr. Jennifer Rice takes us along on a day in her life as a nurse practitioner doing in-home physical exams. Finally, last but not least, first time author Cathy Magowan wrote a commentary on her mission to bring back the certification exam for home care nurses. Home care is a very important and growing specialty, and as with all specialties, certification is needed to assure patients and home care agencies of provider competence. Help Cathy make her quest for a home care nurse certification exam reality-demand the exam!




Click on Detroit. (2014). Cancer doctor whistleblower: Did state ignore allegations? Retrieved from[Context Link]


Department of Licensing and Regulatory Affairs. (2015). Welcome. Retrieved from[Context Link]